Nurses’ knowledge and prevalence of malnutrition risk in older persons within a Maltese rehabilitation hospital

Abstract

Background Malnutrition in the older persons admitted into rehabilitation hospitals, has been associated with poor health outcomes for the older persons (Dionyssiotis, Chhetri, Piotrowicz, Gueye & Sánchez, 2017). Therefore, routine malnutrition screening, to identify older persons at risk of malnutrition is recommended (American Society for Parenteral and Enteral Nutrition (ASPEN), 2011). Nurses with the right knowledge base on malnutrition in older persons, will help to identify older persons at risk of malnutrition (Bauer, Halfens, & Lohrmann, 2015). Nurses are required to refer the older person found to be at risk of malnutrition appropriately for an assessment by a dietitian, where a care plan is devised and acted upon. Aims The aims of this study were to determine the knowledge on malnutrition in older persons of nurses, working at Karin Grech Rehabilitation Hospital (KGRH). Together with, establishing the prevalence of risk of malnutrition in older persons, upon admission to KGRH. As well as, determining the referral rate of older persons, found at risk of malnutrition, to the Department of Nutrition and Dietetics (DND) at the same hospital. Design A cross-sectional, quantitative research design was employed in this study. Nurses’ knowledge on malnutrition in older persons was assessed using the Knowledge of Malnutrition–Geriatric (KoM-G) questionnaire. The KoM-G was self-administered by 105 nurses working within the wards at KGRH. Content analysis of 150 medical files, of older persons aged 65 years or over, admitted to KGRH over a two-month period was undertaken. This served to collect data on variables of interest regarding the older persons including, whether referred or otherwise to the DND at KGRH and the Mini Nutritional Assessment-Short Form (MNA-SF) score. A score of 0-11 on the MNA-SF was used to determine the prevalence of risk of malnutrition in older persons. Results The mean percentage knowledge score of nurses working at KGRH, on malnutrition in older persons was 51.3%. There was no association between the mean percentage knowledge score of nurses and their age, gender, years of nursing experience or highest academic qualification. The prevalence of risk of malnutrition in older persons, upon admission to KGRH stood at 80.7%. There was no association between the older persons’ age or gender and their nutritional status. From those identified as at risk of malnutrition, 50.4% were referred to the DND for malnutrition assessment and management. The age, gender or MNA-SF score, of the older persons identified as at risk of malnutrition, were not associated with referral to the DND for malnutrition assessment and management. Conclusion A deficit in the knowledge of nurses working at KGRH, on malnutrition in older persons was identified. Moreover, this study recognised that the majority of older persons were at risk of malnutrition upon admission to KGRH. Just over half of those at risk of malnutrition were referred for malnutrition assessment and management. The findings suggest that, changes in clinical practice, updating of polices, education for health care professionals, older persons and their relatives, as well as further research on malnutrition in older persons are warranted.